Prognostic Implications of OSA in Acute Coronary Syndrome by Obesity Status

Hao, Wen; Wang, Xiao; Fan, Jingyao; Guo, Ruifeng; Gong, Wei; Yan, Yong; Zheng, Wen; Qu, Bin; Ai, Hui; Ma, Changsheng; Ma, Xin‐Liang; Nie, Shaoping

doi:10.1016/j.chest.2023.02.001

Cited by 6 publications

(5 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…OSA has been shown to initiate and worsen coronary atherosclerosis and is closely linked to poor outcomes in patients with acute coronary syndrome (ACS) 2,3) . In our previous report, the presence of OSA predicted adverse cardiovascular events after ACS in different subpopulations 4,5) . Resting heart rate (RHR) is a clinical parameter that represents the number of heartbeats per minute in an individual's tranquil state and serves cardiac arrest or cardiogenic shock;(2) history of malignancy; (3) inability to complete sleep monitoring tests; (4) atrial fibrillation; (5) patients with predominantly central sleep apnea (≥ 50% central events and central apnea-hypopnea index (AHI) of ≥ 10 breaths/hour) and those already undergoing regular continuous positive airway pressure treatment (＞4 hours/day or ＞21 days/month).…”

Section: Introductionmentioning

confidence: 83%

“…Secondary endpoints include individual events of MACCE. All endpoints were defined according to the proposed definitions by the Standardized Data Collection for Cardiovascular Trials Initiative 18) and have been previously described 5,19) . For patients experiencing multiple events, the counting was based on the first occurrence from the baseline.…”

Section: Endpoints and Follow-upmentioning

confidence: 99%

See 1 more Smart Citation

The Long-Term Prognostic Role of Nighttime Resting Heart Rate in Obstructive Sleep Apnea in Patients with Acute Coronary Syndrome

Xin,

Ai,

Gong

et al. 2024

JAT

Self Cite

View full text Add to dashboard Cite

Aim: A close relationship exists between resting heart rate (RHR) and obstructive sleep apnea (OSA). Still, the prognostic importance of nighttime RHR in patients with acute coronary syndrome (ACS) with or without OSA remains unclear. Methods: In this prospective cohort study, OSA was defined as an apnea–hypopnea index of ≥ 15 events/h, and the high nighttime RHR (HNRHR) was defined as a heart rate of ≥ 70 bpm. The primary endpoint was a major adverse cardiovascular and cerebrovascular event (MACCE), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for heart failure. Results: Among the 1875 enrolled patients, the mean patient age was 56.3±10.5 years, 978 (52.2%) had OSA, and 425 (22.7%) were in HNRHR. The proportion of patients with HNRHR is higher in the OSA population than in the non-OSA population (26.5% vs. 18.5%; P ＜0.001). During 2.9 (1.5, 3.5) years of follow-up, HNRHR was associated with an increased risk of MACCE in patients with OSA (adjusted HR: 1.56, 95% CI: 1.09–2.23, P =0.014), but not in patients without OSA (adjust HR: 1.13, 95% CI: 0.69–1.84, P =0.63). Conclusions: In patients with ACS, a nighttime RHR of ≥ 70 bpm was associated with a higher risk of MACCE in those with OSA but not in those without it. This identifies a potential high-risk subgroup where heart rate may interact with the prognosis of OSA. Further research is needed to determine causative relationships and confirm whether heart rate control impacts cardiovascular outcomes in patients with ACS-OSA.

show abstract

Section: Introductionmentioning

confidence: 83%

Section: Endpoints and Follow-upmentioning

confidence: 99%

The Long-Term Prognostic Role of Nighttime Resting Heart Rate in Obstructive Sleep Apnea in Patients with Acute Coronary Syndrome

Xin,

Ai,

Gong

et al. 2024

JAT

Self Cite

View full text Add to dashboard Cite

show abstract

“…This condition is prevalent among ACS patients in China, where diabetic ACS patients are considerably greater risk of unfavorable hospital outcomes than people without diabetes. [12] Obesity in this context pertains to whether respondents have a history of obesity and its connection with ACS [13] . Obesity is linked to an March 2024 | Vol 5 | Article 3 increased risk of ACS across various lifestyle behavior subgroups, including both healthy and less healthy ones.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity is linked to an increased risk of ACS across various lifestyle behavior subgroups, including both healthy and less healthy ones [13] . Hyperuricemia, characterized by elevated uric acid levels in the blood, has demonstrated associations with ACS in numerous studies.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Impact of Modifiable Risk Factors on Acute Coronary Syndrome: A Case Control Study

Kusuma,

I Gede Bagus Gita Pranata Putra

2024

CCJ

View full text Add to dashboard Cite

Highlights: 1. Smoking duration, dyslipidemia, hypertension, diabetes mellitus, obesity, and hyperuricemia, are significantly associated with ACS. 2. Obesity and hypertension are identified as risk factors for inpatient ACS. - Background: Acute coronary syndrome (ACS) is defined by the abrupt reduction or total obstruction of blood flow to the myocardium. Recognized risk factors for ACS include conditions such as hypertension, dyslipidemia, smoking, obesity, diabetes mellitus, hyperuricemia, as well as variables like age, gender, and family history of the ailment. The objective of this research was to examine the prevalence and importance of modifiable risk factors associated with ACS. Material and Methods: The study is structured as a prospective case-control study. The research sample comprises 100 ACS patients, categorized into three groups: STEMI, NSTEMI, and UAP. The Chi-Square test and logistic regression were used to examine the samples. The threshold for statistical significance was set at p<0.05. Results: ACS occurred more frequently in male patients (54%) and those aged ≥ 40 years (85%). Several factors demonstrated significant associations with ACS, including smoking habits, dyslipidemia, hypertension, diabetes mellitus, obesity, and hyperuricemia. Among these, inpatient ACS was notably linked with obesity (OR: 7.42; 95% CI: 1.48-37.11; p=0.015) and hypertension (OR: 0.13; 95% CI: 0.03-0.53; p=0.005). The presence of ACS was also correlated with a notable increase in inpatient care, with obesity and hypertension emerging as risk factors for inpatient ACS. Conclusion: ACS was more common in males and individuals aged 40 or older, with significant associations identified between ACS and various factors, including smoking, dyslipidemia, diabetes, obesity, hyperuricemia, and hypertension, with obesity and hypertension specifically linked to inpatient ACS.

show abstract

“…This is an ancillary study of the OSA-ACS project (NCT03362385), which is a single-center, prospective, cohort study aimed at investigating the association between OSA and cardio-cerebrovascular events of ACS patients [ 13 – 15 ]. In brief, patients included in the project were hospitalized for ACS in Beijing Anzhen Hospital, Capital Medical University from January 2015 and December 2019, whose age was in a range of 18 to 85 years old.…”

Section: Methodsmentioning

confidence: 99%

Effect of obstructive sleep apnea on prognosis in patients with acute coronary syndromes with varying numbers of standard modifiable risk factors: insight from the OSA-ACS study

Wang,

Zhang,

Hao

et al. 2023

J Thromb Thrombolysis

Self Cite

View full text Add to dashboard Cite

Background Standard modifiable risk factors (SMuRFs) increase the risk of cardiovascular events in patients with acute coronary syndrome (ACS) and are also strongly associated with obstructive sleep apnea (OSA) in a bidirectional relationship. However, the association of OSA with recurrent cardiovascular events in ACS patients based on the number of SMuRFs remains unclear. Hence, we aimed to elucidate the prognostic implication of OSA in ACS patients stratified by the number of SMuRFs. Methods This was a post hoc analysis of the OSA-ACS study (NCT03362385), including 1927 patients admitted for ACS and undergoing portable sleep monitoring. OSA was defined as an apnea hypopnea index ≥ 15 events/h. The primary endpoint was major adverse cardiovascular and cerebrovascular event (MACCE) including cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina or heart failure, and ischemia-driven revascularization. Cox proportional hazards model and Kaplan-Meier analysis were used to investigated the relationship between OSA and subsequent cardiovascular events after patients were stratified by the number of SMuRFs. Results Among 1927 patients enrolled, 130 (6.7%) had no SMuRF, 1264 (65.6%) exhibited 1–2 SMuRFs and 533 (27.7%) presented 3–4 SMuRFs. With the increase of the number of SMuRFs, the proportion of OSA in ACS patients tended to increase (47.7% vs. 51.5% vs. 56.6%), but there was no significant difference between them (P = 0.08). After the stratification of ACS patients via SMuRF numbers and adjustment for confounding factors, fully adjusted Cox regression indicated that OSA increased the risk of MACCE (adjusted HR, 1.65; 95%CI, 1.06–2.57; P = 0.026) and ischemia-driven revascularization (adjusted HR, 2.18; 95%CI, 1.03–4.65; P = 0.042) in ACS patients with 3–4 SMuRFs. Conclusions In hospitalized ACS patients, OSA is associated with an increased risk of MACCE and ischemia-driven revascularization among patients with 3–4 SMuRFs. Therefore, screening for OSA should be emphasized in ACS patients with 3–4 SMuRFs, and intervention trials should be prioritized in these high-risk patients.

show abstract

Prognostic Implications of OSA in Acute Coronary Syndrome by Obesity Status

Cited by 6 publications

References 46 publications

The Long-Term Prognostic Role of Nighttime Resting Heart Rate in Obstructive Sleep Apnea in Patients with Acute Coronary Syndrome

The Long-Term Prognostic Role of Nighttime Resting Heart Rate in Obstructive Sleep Apnea in Patients with Acute Coronary Syndrome

Prevalence and Impact of Modifiable Risk Factors on Acute Coronary Syndrome: A Case Control Study

Effect of obstructive sleep apnea on prognosis in patients with acute coronary syndromes with varying numbers of standard modifiable risk factors: insight from the OSA-ACS study

Contact Info

Product

Resources

About